Seizure precipitants and perceived self-control of seizures in adults with poorly-controlled epilepsy

This study was set up in order to investigate the prevalence and nature of seizure precipitants and self-control behaviours in adults with intractable seizures. A semi-structured interview was conducted with 100 patients attending neurology or neuropsychiatry epilepsy out-patient clinics. The interview included six questions regarding seizure precipitants, the extent to which the patients seek and avoid precipitants, and their ability to induce or abort seizures. The study revealed that over 90% of the participants could identify at least one seizure precipitant. Stress, depression, tiredness and the menstrual cycle were the most common precipitants reported. In addition, 65% of the participants could identify at least one 'low-risk' situation in which seizures were unlikely to occur. Fifteen percent reported they could induce a seizure, 52% said that they consciously try to avoid seizure precipitants and 47% said they could sometimes stop their seizures from happening. These results indicate that the majority of the sample could identify factors which trigger their seizures, and that some of the participants engage in attempts to reduce their seizure frequency by avoiding these factors and by controlling the onset of their seizures. The possible mechanisms involved in the relationship between precipitants and seizure genesis are discussed.